To investigate the effect ultrasound-guided ilioinguino-iliohypogastric nerve block (IINB) combined with local anesthesia in tension-free inguinal hernia repair in elderly patients.

A prospective study was conducted on 104 elderly patients who underwent tension-free inguinal hernia repair in Hanchuan People's Hospital of Hubei Province from February 2019 to February 2021. Patients were divided into experimental group and control group using a random number table method, with 52 patients in each group. The control group was given subarachnoid nerve block anesthesia, and the experimental group was given IINB combined with local anesthesia under ultrasound guidance. The visual analogue scale (VAS) of pain at 24, 48, and 72 hours after operation was compared between the two groups, and the stress response indexes [interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), C-reactive protein (CRP) and cortisol] before and 24, 48 hours after surgery, and hemodynamic [heart rate, mean arterial pressure (MAP), and oxygen saturation (SpO₂) levels] at T0 (before anesthesia), T1 (after anesthesia for 10 minutes), T2 (during skin incision), T3 (when pulling hernia sac) and T4 (during skin suture) were compared.

At rest, the VAS scores of the experimental group were lower than those of the control group at 24, 48, and 72 h postoperatively and the difference was statistically significant (P<0.05). During activity, the difference in VAS scores between the two groups was not statistically significant at 24 h after surgery (P>0.05), and the differences in VAS scores at 48 and 72 h after surgery were statistically significant (P<0.05). The heart rate of the experimental group was higher than that of the control group at the moments of T1, T2, T3, T4, and the MAP values of the experimental group were higher than those of the control group at the moments of T1 and T4; the SpO₂ values of the experimental group were higher than those of the control group at the moments of T2 and T3 (P<0.05); serum IL-6, TNF-α, CRP and cortisol levels in the experimental group were lower than those in the control group at 24 and 48 h after surgery (P<0.05). The incidence rate of total adverse reactions in the experimental group was lower than that in the control group (9.62% vs 23.08%), but the difference was not statistically significant (χ²=1.847, P=0.065).

Under ultrasound guidance, IINB has good anesthesia effect and high safety in tension-free inguinal hernia repair in elderly patients, which can effectively reduce stress and inflammatory response during perioperative period and maintain hemodynamic stability of the body.